Refer To Grow

Discover what our clients have to say about Easy Care Disabilities. Watch our testimonials and learn how we empower individuals to live safely and comfortably with dignity and independence.

 

Ted Care Referrals Form

Delivering core support is at the heart of our commitment, ensuring individuals receive essential assistance and guidance tailored to their unique needs.

Full Name*
Gender*
Gender (If Other)
Date of Birth*
Phone Number*
Email*
Street Address*
Suburb*
State*
Postcode*
Your NDIS Information
Please complete:
Your NDIS Number*
Disability
Support Required (Hours/Week)*
Start Date Of NDIS Plan*
End Date Of NDIS Plan*
Total NDIS Budget
Funds Management*
Do you have a Plan Manager?
Plan Manager Name
Plan Manager Phone
Plan Manager Email
Support Needed
Do you want to attach an NDIS plan?*
Please upload your NDIS Plan:
Maximum file size: 20 MB
(jpg, png or pdf) - Maximum Upload 20MB.
Would you like to provide any further information?*
Regarding your NDIS plan, and more.
Are there anything else we need to know about yourself and the plan?
Please select the contact option:
What is the best time to contact you?
Representative Contact Name
Representative Contact Role
Representative Email Address
Representative Phone Contact
What is the best time to contact your representative?
Please accept:*

Book an Appointment

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